=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043029739
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VALLEY INFECTIOUS DISEASES SPECIALISTS PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/06/2025
-----------------------------------------------------
Last Update Date | 09/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 110 E SAVANNAH AVE BLDG B102
-----------------------------------------------------
City | MCALLEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78503-1238
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-321-7766
-----------------------------------------------------
Fax | 956-513-0494
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 110 E SAVANNAH AVE BLDG B102
-----------------------------------------------------
City | MCALLEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78503-1238
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-321-7766
-----------------------------------------------------
Fax | 956-513-0494
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | LIA PATRICIA SUAZO HERNANDEZ
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 956-249-0318
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RI0200X
-----------------------------------------------------
Taxonomy Name | Infectious Disease Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------